Strabismus after balanced medial plus lateral wall versus lateral wall only orbital decompression for dysthyroid orbitopathy

Purpose, This study aimed to determine the relative incidence and time cour se of new-onset strabismus after balanced medial plus lateral wall orbital decompression versus decompression of the lateral wall alone for dysthyroid orbitopathy. Methods: The study design was a retrospective nonrandomized comparative cas e series. Thirty-two consecutive patients underwent balanced medial plus la teral wall orbital decompression or lateral wall orbital decompression for dysthyroid orbitopathy. The incidence, duration, and treatment of postopera tive strabismus was recorded for each patient. Results.' Significant preoperative strabismus was present in 31% (4/13 pati ents) of the balanced decompression group and in 26% (5/19 patients) of the lateral wall decompression group. Only 25% (1/4) of cases of preexisting s trabismus in the balanced decompression group resolved postoperatively with out muscle surgery, whereas 60% (3/5) of cases in the lateral wall decompre ssion group resolved postoperatively without surgery. Preoperative strabism us was absent in 69% (9/13) of patients in the balanced decompression group and in 74% (14/19) of patients in the lateral wall decompression group. Ne w-onset, persistent postoperative strabismus developed in 33% (3/9) of pati ents in the balanced decompression group and in 7% (1/14) of patients in th e lateral wall decompression group. Conclusion: Lateral wall orbital decompression may produce less new-onset, persistent postoperative strabismus than balanced medial plus lateral wall orbital decompression for dysthyroid orbitopathy.